News Reports for June 20, 2009

Authorities baffled how man from isolated community contracted swine flu

http://www.thewest.com.au/defa...

Health authorities are trying to establish how a 26-year-old WA man from the most remote Indigenous community in the world contracted swine flu to become the first person in Australia to die  with the virus.

The man from the isolated community of Kiwirrkurra, in the Gibson Desert, died in the Royal Adelaide Hospital late yesterday.

He was just 26 and suffering existing health conditions.

Kiwirrkurra is home to around 300 people and lies 1200 km east of Port Hedland and 700km west of Alice Springs.

It is understood members of the community have been told not to leave the area because of the potential danger of spreading the virus.

It has yet to be established if the man actually died of swine flu but it has been confirmed that he had the virus.

The man had been sick for three weeks and had been in a critical condition since Monday after being transferred to Royal Adelaide Hospital from Alice Springs.

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by: magdelaine @ Sat Jun 20, 2009 at 00:23:21 AM CDT

If this is true

Doesn't it mean that the virus has been circulating in Australia for a while? Or is it possible he contracted it in the hospital?

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by: magdelaine @ Sat Jun 20, 2009 at 00:25:32 AM CDT

[ Parent ]

both are possible

though I'd be suspicious for hosptital acquisition.

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by: DemFromCT @ Sat Jun 20, 2009 at 08:14:13 AM CDT

[ Parent ]

Outbreak fears after swine flu death

http://www.news.com.au/adelaid...

HEALTH authorities have visited a remote Aboriginal community amid fears of a swine flu outbreak after one of its members died in the Royal Adelaide Hospital.

The 26-year-old from Kiwirrkurra - a tiny district 680km west of Alice Springs - died on Friday after developing Influenza A (H1N1). He was suffering from pneumonia and other ailments when diagnosed with swine flu.

The WA Health Department has launched an investigation into whether his health care was compromised because of where he was living. Authorities are also trying to ascertain whether the man caught the disease in the isolated community and, if so, how it reached there.

SA chief medical officer Professor Paddy Phillips said authorities were tracing the man's movements in an effort to find the source of the infection.

"He became unwell some weeks ago and was being followed up," Prof Phillips said. "We're getting more details on that. On Monday and Tuesday he was unwell and was transferred to Alice Springs Hospital on Tuesday."

By Wednesday, the man's condition had deteriorated and he was airlifted to the RAH. He tested positive for swine flu on Thursday and died the next day.

Snip

Dr Weeramanthri said swine flu had been detected in several remote Aboriginal communities near the Northern Territory and WA border.

The WA department will be sending a public health team to Kiwirrkurra early this week to support local health staff and make an assessment of the situation.

Snip

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by: magdelaine @ Sat Jun 20, 2009 at 12:01:41 PM CDT

[ Parent ]

H1N1 flu death toll in US, Canada reaches 100

WASHINGTON: Figures released Friday by US and Canadian health authorities show that the H1N1 flu pandemic has killed 100 people in Canada and the United States. Eighty-seven people died from the disease in the United States, the Centers for Disease Control reported, adding that there were 21,449 confirmed cases. The figures are a jump from the previous report on June 12, when 44 people were reported dead and 17,855 cases were confirmed.

In Canada, the world's third most affected country, health authorities reported a 13th death and 5,710 confirmed cases of A(H1N1) flu.

In Mexico, where the flu strain was first spotted, authorities reported 113 killed by the disease and the number of confirmed infections at more than 7,000.
(Snip)
Some affected countries no longer keep track of all cases according to the UN health agency, while others do not report for each of the thrice-weekly bulletins. http://www.channelnewsasia.com...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 00:26:27 AM CDT

Historians unearth RI's pandemic records

http://www.thejakartapost.com/...

At a time when the world was much less connected than it is now, then Dutch East Indies (now Indonesia) was not spared by the Spanish Flu pandemic of the early 19th century, researchers said Friday.

Spanish Flu infected more than 500 million people and killed 20-40 million. It killed more people than any other pandemic in recorded history.

University of Indonesia (UI) historian Kresno Brahmantyo said the preliminary findings of the research, which began earlier this year, were expected to help medical and non-medical sectors prevent the spread of H1N1-A (also referred to as "swine flu"), which is currently spreading around the world.

"We hope to contribute to the preventive efforts because from our findings we can learn from the past and we want to prove that influenza pandemics did not only affect far-away lands," Kresno said, adding that the group credited their findings to prominent historian Collin Brown, the author of Influenza Pandemic 1918 in Indonesia.

Shadowed by the mysteries left by the 1918 pandemic, the World Health Organization announced last week that the world is facing the beginning of a global pandemic of the H1N1-A virus.

First detected in Mexico City in March, the disease, with symptoms resembling a common cold, has now claimed 167 lives in 74 countries, including Indonesia's closest neighbors Singapore and Malaysia. Indonesia, hardest hit by bird flu (the H5N1 virus), has recorded no H1N1 cases to date.

Kresno said most of the facts the group had analyzed were researched from old archives of staatsblad (state papers or legislation), correspondences and journals published by Dutch colonial government officials, physicians and missionaries.

"We were surprised with the findings because we found another interesting fact that long before 1918 the colonial administration had already reported influenza cases in Ambon in 1852. This is not mentioned in Collin Brown's book," he said.

The Ambon cases were recorded in an 1891 medical journal, Geneeskundig Tijdschrift voor Nederlandsch-Indie Deel.

"The journal says the virus initially affected indigenous peoples but later was found among European military personnel stationed in Ambon," Kresno said.

Influenza cases were also reported to have infected Dutch troops sent to Muara Teweh (Central Kalimantan) and those stationed in Padang Panjang (West Sumatra) in 1890. More evidence, however, is needed to confirm whether the 18th century influenza is related to the 1918 virus, he said.

Unlike the Ambon cases, there was a different pattern in the spread of the disease in 1918, Kresno said. The initial cases were reported from military personnel coming off ships from Europe.

There was also a copy of a wired telegram signed by the Dutch Consulate General in Singapore, warning Batavia (now Jakarta) to prohibit ships from Hong Kong that were feared to be carrying infected crews.

"The colonial administration even issued a staatsblad which was later called the Influenza Ordinantie. This ordinance was distributed to health agencies, schools, sea ports and ship's captains," he said.

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by: magdelaine @ Sat Jun 20, 2009 at 00:35:22 AM CDT

Same story in Jakarta Globe.

Flu Chief Says Indonesia Not Immune From Pandemics
June 20, 2009, http://thejakartaglobe.com/nat...
Indonesians were warned on Friday that the country was not immune to the influenza pandemic and that a past flu epidemic had in fact claimed at least 1.5 million lives during the colonial period.

"We need to stay alert as we already have a history of flu epidemics and there's no reason it won't happen again," said Bayu Krisnamurthi, the executive chairman of the National Committee for Avian Influenza Control and Pandemic Preparedness (Komnas FBPI).

He was responding to a presentation by University of Indonesia historians about past outbreaks of flu in the country. The historians found old Dutch East Indies government documents showing that the archipelago was struck by a large-scale flu outbreak in 1852, which began in Ambon, Maluku, and was transmitted widely. Research team member Kresno Brahmantyo said that at least 1.5 million people died from the epidemic, from a population of about 30 million at the time.
(more)

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

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by: History Lover @ Sat Jun 20, 2009 at 12:24:25 PM CDT

[ Parent ]

India: H1N1: is Guj ready?

http://www.dnaindia.com/india/...

Ahmedabad: DNA approached the authorities of hospitals run by the state government and the Ahmedabad Municipal Corporation (AMC) and asked them about their preparedness in case of a swine flu outbreak in Gujarat. Here's what they had to say...

Stock of medication...
Officials of Civil and other municipal hospitals in Ahmedabad did not divulge the figures of the medicines for H1N1 in stock. "We have enough stock of medicine to handle any situation. The facilities and medication are adequate for treatment as well as precaution," was the common answer.

Is this adequate?
Superintendent of VS hospital, Dr MH Makwana refused to comment on this. He disconnected the call after saying that deputy municipal commissioner Capt Dilip Mahajan will answer such questions. Mahajan, however, was unable to answer the same.

Snip

Quote Unquote
"We have 12,000 doses of Tamiflu and reserved 280 beds. We are following the guidelines of the government of India and the World Health Organisation."
--Jaynarayan Vyas, heath and family welfare minister

Comment: Gujarat has a population of 50,596,992. I lived in India once. I know that poor villagers will not get the same  treatment as city folk. As a whole are woefully underprepared...the whole article is worth reading.

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by: magdelaine @ Sat Jun 20, 2009 at 00:46:19 AM CDT

The pandemic is here

http://www.theglobeandmail.com...

So it's here at last. After months of will-it-won't-it anticipation, H1N1 officially went pandemic on June 11.

Yet despite increasing numbers of cases in over 70 countries, many still think it a fuss over nothing: "What's the big deal? It's just ordinary flu." It is worrying that even Canadians are saying this, although they know from recent memory what it is to experience a big disease outbreak.

Many in Britain are saying the same thing. One high-profile commentator, Simon Jenkins in the Guardian newspaper, asserted that swine flu was a panic stoked in order "to posture and spend," saying that health scares such as this enable media-hungry doctors, public-health officials and drug companies to benefit by manipulating fright.

Those who dismiss H1N1 as a panic-fest are profoundly wrong. This "ordinary flu" might have real consequences to many Canadians.

Canada has an excellent flu vaccination program and good access to medical care. Nonetheless, 6,000 to 8,000 Canadians die of seasonal flu each year, mostly older people or those with other health problems. These are people's mothers and grandfathers, uncles and fathers. Ordinary flu causes a great many deaths, even in a country such as Canada.

Let's say that H1N1 continues to be mild and is no worse than seasonal flu. "Mild" means having up to five days feeling really unwell with fever, cough, sore throat and muscle aches, and then a further week before one feels able to return to work and normal life.

The old story about the difference between flu and a cold holds good: If a $50 bill is dropped outside your front door, if you've got a cold, you'll go pick it up; if you've got flu, not even $50 will get you out of bed.

This is a novel flu. While people over 50 seem to have some immunity, perhaps because of the Asian flu of 1957, those who are younger have not been exposed before and have no defences in place. Current H1N1 attack rates are about 20 per cent. That is, one in five people exposed to this new flu will come down with symptoms like the ones above; exposure can result from merely touching a surface where there are viruses, because someone else has touched it. Pretty much everyone who comes into contact with other people will be exposed to this flu, sooner or later.

4-PER-CENT IMPACT ON GDP

That means 20 per cent of the population becoming sick, with perhaps another 10 per cent of the working population home looking after them. Think about the effects on business, on transport, on day-to-day life, of so many people being off sick at the same time. Flu is estimated to have a 4-per-cent impact on a country's GDP.

And think about its effect on hospitals. Not on its effect on patients requiring intensive care, but its effect on staffing. A tanker drivers' strike in Britain bought our hospitals to a halt in less than a week. Why? Because schools didn't have fuel for heating and were closed, working mothers had to stay home to look after their children. Where are there are large proportion of working mothers? In nursing and allied health services.

There are 33 million people in Canada. At an attack rate of 20 per cent, six million people would develop flu. The death rate in Canada is currently tiny, at roughly 0.1 per cent (12 deaths, 4,905 cases). But 0.1 per cent of six million is 6,000. These 6,000 will not be just the old and the sick, whose deaths, extraordinarily, don't seem to greatly concern many commentators, but will include previously healthy twentysomethings (such as three of those admitted to intensive care units in Britain), pregnant women and a disproportionate number of those sections of the population that are genetically particularly susceptible. Such effects are already appearing in Canada with outbreaks of severe illness among previously healthy native people in Manitoba.

This is not scaremongering. This is reality.

Snip

Comment: Someone in the media is finally crunching the numbers. Whole article is worth reading.

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by: magdelaine @ Sat Jun 20, 2009 at 00:58:43 AM CDT

bloggers please start a meme!

A blogger may sometimes ask him/herself a question, like What would it be like in my place?  And then asks that question of other bloggers, who will link to the initial blog.

Say DemFromCT runs the numbers for CT.  Others for NYC or wherever.

How about that for a Pandemic Awareness Campaign?

There could be 2 sets of figures: one for the threshold between Cat1 and Cat2, and another for the threshold between Cat4 and Cat5.  Just CAR and CFR for each, so 4 figures.  And the fraction of CAR corresponding to the young and healthy.

I'm seeing a post called "running the numbers locally".  Please, do beat me to it.  Really, do.

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

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by: lugon @ Sat Jun 20, 2009 at 01:16:35 AM CDT

[ Parent ]

Think You Have Swine Flu? You May Never Know...

http://www.wgrz.com/news/local...

Last week Dr. Roger Forden, a doctor in practice for 31 years at Kenmore Pediatric Associates, saw two patients he thinks have swine flu. But won't he be able to definitively say yes or no.

Dr. Roger Forden says, "May have it and we won't know for sure."

He followed the regular procedure, sent the samples to the local Quest laboratory for testing and they came back positive for influenza A. But, he was told the state lab that tests specifically for H1N1 or swine flu, is no longer accepting samples from Quest or any private lab.

"So, the frustration that we feel is that we're not able to identify, really, if these kids have influenza A or swine flu which is subtype H1N1," says Forden.

The state says it is accepting some samples. But, Erie County's Health Department tells us none from private labs like Quest. They must be referred by Erie County or another County Health Department.

Currently, Erie County is only referring certain patients for testing. For example, patients who are gravely ill, have some kind of pre-existing condition, or other outside factor.

The State Health Department sent this statement:

"The State Health Department's Wadsworth Laboratory continues to test specimens for H1N1, with priority given to hospitalized patients with influenza-like illness. Health care providers are urged to consult with their county health department on whether a suspect case of H1N1 should be submitted for testing. Testing is no longer needed to determine the presence of H1N1 in schools or communities, as we know that the virus is now widespread in the State. Also, testing is not needed by a health care provider to diagnose an individual with influenza and to prescribe antiviral treatment."

Kristin Donnelly asks, "Do you think that's a good enough answer?"

"No, because we're not really sure how we can help these families identify if their kids have swine flu or not. True, it's not going to make a difference in the treatment but everyone is really concerned about this," Forden says.

Patients with swine flu and influenza A are treated the same way.

Comment - I wonder if those people who allegedly went to the hospital more than once and were sent home (and who are now dead) would agree with the last bolded statement. ABBF can be a deadly "disease".

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by: magdelaine @ Sat Jun 20, 2009 at 01:13:48 AM CDT

if it's flu it's swine flu

since seasonal flu is not really present any more.

During seasonal flu season we don't even do rapid tests except if you are hospitalized because too many people are ill.

if you have flu symptoms, you have flu.

I like the explanatory articles about how many are not being tested... it is very real. But it shouldn't be presented as 'doing it wrong' if people are not tested.

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by: DemFromCT @ Sat Jun 20, 2009 at 08:17:59 AM CDT

[ Parent ]

Dem, I agree but

I've been shocked by stories of people presenting themselves for treatment and being turned away because of negative H1N1 tests or a disbelief in the possibility of swine flu in that patient, and those stories reported because the patient later died. This is probably happening elsewhere with patients who don't die. (ABBF)

And, quite frankly, young folks who are so sick they end up seeing their doctor or going to the ER with this virus need to be monitored as closely as you would an elderly person or an infant with seasonal flu. And without a positive H1N1 declaration I wonder if that will happen.

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by: magdelaine @ Sat Jun 20, 2009 at 09:09:42 AM CDT

[ Parent ]

agree on close monitoring of everyone

but in CT, for example, with 700+ documented cases and many, many more real cases, a handful (4) deaths and some hospitalizations, docs should not need a positive H1N1 call from the state to do the right thing. Everyone knows there's an 'extended' flu season.

Now, let's just say that there are 35,000 cases or more of flu and two make the paper because the arrogant or harried or ignorant doc didn't consider flu. That's terrible and really should be considered unacceptable (particularly with a bad outcome), yet it doesn't reflect on the way flu is being handled for everyone else. That's all I'm saying.

Patients should be asking 'do I have flu', docs should be saying 'certainly could, but I don't need to test to know that' and patients should be saying 'ok, what do i do now?" and take it from there.

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by: DemFromCT @ Sat Jun 20, 2009 at 09:47:01 AM CDT

[ Parent ]

I posted an article a few days ago

that said that testing is showing seasonal flu still circulating. I think it was a cidrap article, most of the flu circulating is swine flu though.

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

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by: mojo @ Sat Jun 20, 2009 at 12:44:24 PM CDT

[ Parent ]

Here is the article

http://www.newfluwiki2.com/sho...

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

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by: mojo @ Sat Jun 20, 2009 at 12:46:42 PM CDT

[ Parent ]

yeah

1.8% seasonal.

I think you can safely assume if you have flu it is swine fu.

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by: DemFromCT @ Sat Jun 20, 2009 at 15:43:55 PM CDT

[ Parent ]

Cytokine storm cause in San Diego County's swine-flu fatality?

Cytokine storm considered possible cause in San Diego County's first swine-flu fatality.

A fatal puzzle: Escondido woman's death from swine flu baffles experts

                         By         Keith Darcé,  Union-Tribune Staff Writer      
         2:00 a.m. June 19, 2009

Adela Chevalier didn't fit the profile of someone who might die of swine flu.

The Escondido woman was young, having turned 20 in January. She wasactive and worked two jobs. And she was healthy - family members saidshe never had a serious illness before last weekend.

Statistics on swine-flu patients also were in her favor.

About 70 percent of people in the United States who have been hospitalized for the virus, also called H1N1 influenza A, suffered fromsome underlying health problem, such as asthma, diabetes, chronic heartdisease or a weakened immune system, according to the federal Centersfor Disease Control and Prevention.
snip

[...] Medical examiners still must analyze tiny slices of Chevalier'slung tissue under a microscope to determine where the fluid originatedand whether the volume was large enough to kill her, Wagner said.

If the fluid resulted from a battle spawned by her immune system, it might be evidence of a cytokine storm.
http://www3.signonsandiego.com...

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by: mollyd @ Sat Jun 20, 2009 at 01:56:21 AM CDT

I say all the 20-50 year olds are..

...geting cytokine storms...obviously some worse than others at different points resulting in death (like when someone gets better than way worse). Its a new virus.

And when they say 'pre-existing conditions' its horse crap. Everyone has something wrong with them. I had asthma when I was a kid. Never had it since but if I died from swine flu via cytokine storm they would say 'pre-existing' condition cause they don't know ehat else to say...

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by: blackkitty @ Sat Jun 20, 2009 at 02:48:05 AM CDT

sorry that was suppose to be a reply to the above. n/t

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by: blackkitty @ Sat Jun 20, 2009 at 02:48:42 AM CDT

[ Parent ]

I agree

What is different about the article is them saying it outright, rather than hiding behind mysterious pre-conditions.

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by: mollyd @ Sat Jun 20, 2009 at 02:58:42 AM CDT

[ Parent ]

n/t

I wouldn't say "all" 20-50 year olds. There are countless 20-50 year olds infected with H1N1 who are experiencing only mild symptoms that would otherwise be pretty indistinguishable from seasonal flu. And when someone gets better and than way worse, that's often seen in seasonal flu simply by the emergence of a secondary infection. No?

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by: Vanderjuice @ Sat Jun 20, 2009 at 10:11:43 AM CDT

[ Parent ]

UK - Swine flu test facilities set up

http://news.bbc.co.uk/1/hi/sco...

Dedicated testing facilities for swine flu have been set up across Glasgow, the Scottish Government has confirmed.

It comes after laboratory testing of all cases was resumed in the greater Glasgow area, reversing a decision to allow GPs to make a diagnosis.

Existing NHS accommodation is being used to house nine testing facilities including health centres and clinics.

[snip]

"Members of the public will be assessed either by NHS24 or their GP, as is currently the case, but instead of someone coming to their home to swab them they will now be given an appointment and asked to attend one of the dedicated facilities."

cont.

Comment I can see this repeated elsewhere in the country.

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by: UK - Bird @ Sat Jun 20, 2009 at 04:09:26 AM CDT

Major swine flu alert hits schools

as two girls fall victim to virus pandemic

TWO young children were last night at the centre of the latest swine flu outbreak as the number affected by the virus in Ireland climbed to 18.

A seven-year-old girl sparked a school alert after it emerged that she had contracted swine flu from a visiting American cousin. Health chiefs moved immediately to issue a blueprint of advice to 4,000 schools and colleges around the country.

And Health Minister Mary Harney confirmed that eight million vaccines had been ordered to ensure a blanket immunisation of everyone in the country in the autumn when the virus is expected to be approaching its most virulent stage. "The challenge will be to make sure we can immunise people quickly in an orderly fashion over the winter months," she said. Continued: http://www.independent.ie/nati...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 06:03:30 AM CDT

New interferon response

could offer early control of bird flu virus

Washington, June 20: The cell-signalling protein, interferon type 1, has the potential to reduce H5N1 influenza virus' (bird flu virus) replication in mice, and can thus offer protection in the early stages of infection, according to researchers from Georgia. Continued: http://www.dailyindia.com/show...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 06:11:39 AM CDT

WHO flu alerts 'lead to panic', experts say

http://www.bangkokpost.com/new...

Published: 20/06/2009 at 12:00 AM

Thailand plans to ask the World Health Organisation (WHO) to revise its system of alerting people to the spread of the H1N1 flu virus as it believes that its current method is misleading the public and causing panic...

...But when they look at such countries as the US, Britain, Canada, and Australia, they are surprised to learn that these countries have cancelled their "special measures" against the disease, said Dr Supamit.

more...

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by: sors @ Sat Jun 20, 2009 at 07:41:09 AM CDT

what bollocks

Many virologists say the H1N1 flu is not as virulent as previously feared. Studies show the fatality rate of the H1N1 infection stands at only 0.4%, which is lower than the 1% toll of the average seasonal influenza each year.

Where the heck did they get that from?  Average seasonal flu has a 1% death toll??  That's the equivalent of a Cat 4 pandemic, out of a scale of 5 http://en.wikipedia.org/wiki/P...  We have that happen every year??

Unbelievable!  


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 09:53:08 AM CDT

[ Parent ]

do we have CFR estimates? will we know if/when it gets worse? soon enough?

Those are the big questions in my mind.

My answers:

1) No, we don't know what the CFR is.  What we have with people who are tested is a ceiling, if many mild cases are not tested.  Or not, if many severe cases are not tested.

2) Will we know if/when it gets worse.  No.  Please see #1.

3) Soon enough?  We should be getting ready for the worse right now, if you ask me.  Not even yesterday was "soon enough".  End of rant.

You arm yourself to the teeth just in case.  You don't leave the gun near the baby's hand.

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by: lugon @ Sat Jun 20, 2009 at 11:24:52 AM CDT

[ Parent ]

yes we do

0.4% for Mexico (Fraser et al) 0.2% for the US (CDC)


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 11:26:44 AM CDT

[ Parent ]

My problem with CFR data . . .

is that it comes from the CDC, and I know it's the only source we have, but I don't feel I can trust what they say.

They don't exactly seem very interested in accumulating accurate data - it's hard to get the numbers right when you discourage testing, and seem determined to insist that patients who die almost inevitably had underlying pre-existing medical problems.

I feel as though there are a significant number of cases that are never accurately diagnosed, which I think makes establishing a reliable CFR a difficult thing to manage.

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by: Clawdia @ Sat Jun 20, 2009 at 12:01:11 PM CDT

[ Parent ]

I think the 0.2% is probably reasonably accurate

we really are NOT seeing a large number of deaths, based on the wide circulation of this virus.  Rather it is the age distribution and the rapid deterioration that worries me.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 12:20:51 PM CDT

[ Parent ]

The age distortion

is supposed to be caused by the elderly having pre exposure. If we could add in a notional figure in for an unprotected elderly population it might give a much higher CFR.

What percentage of the elderly normally die from seasonal flu? Or have the CDC already done that?

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by: UK - Bird @ Sat Jun 20, 2009 at 12:48:41 PM CDT

[ Parent ]

'healthy' people are far more likely to be accurately diagnosed

after death, simply because people weren't expecting them to die. Doesn't the US do autopsies on anyone who dies unexpectedly?

We accept the 1918 figures of healthy individuals being killed by the disease but have no real information on what hidden ailments they may have had.

Whether we like it or not, certain conditions make you more vulnerable. Why would you not expect a large proportion of the dead to be made up of people with pre-existing conditions?

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by: UK - Bird @ Sat Jun 20, 2009 at 12:43:49 PM CDT

[ Parent ]

I don't think there were that many in 1918

We accept the 1918 figures of healthy individuals being killed by the disease but have no real information on what hidden ailments they may have had.

that had hidden ailments, for 2 reasons.  There were far fewer people with chronic conditions because of better survival now.  Second, if there's any doubt about the ability of the virus to kill perfectly healthy young people, you only need to read about the terrible death toll in the army.  These were young fit recruits, there wouldn't be a lot with hidden conditions, but there were some really high CFR there.  

For example, Crosby wrote about the troop ships crossing the Atlantic.  Some of these ships had more complete record than others, and the CFR among the recruits being shepherded across the Atlantic was 6.43%.  With such a high CFR, I would say that the density of men being packed together played a much bigger role than any hidden health conditions in the troops.

As an aside, Crosby makes the observation that, in comparison, the CFR was 1.5% among the sailors, who had been running these troop ships back and forth throughout the summer into the fall of 1918, even though the AR among the 2 groups were similar.  That to me is another sign that prior exposure protected against death in the second wave.  


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 17:24:19 PM CDT

[ Parent ]

To piggy back on what Susan just said

In 1918 we had far less medical interventions than we do now. We didn't have dialysis, we didn't have chemo, we didn't have insulin, we didn't have penicillin, ventilators, organ transplants..yadayadayada. Seriously ill people just died. Now we have millions upon millions of people kept alive on various medications and surgical interventions. Add to that we have much higher numbers of asthmatics (due to air pollution), the obese, people with heart disease, lung disease, cancer, HIV/AIDS and all sorts of other new ailments caused by what we have done to ourselves and our environment.   As someone above wrote, who doesn't have some underlying condition of some sort? The truly 100% healthy are very very rare in our modern world.  So keep that in mind when we think about a second wave with increased transmissability and virulence overwhelming our health care systems.

Always have a plan B.

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by: maryinhawaii @ Sat Jun 20, 2009 at 21:40:14 PM CDT

[ Parent ]

CDC doesn't distort data

I think you have to get over this 'I don't trust them', but on the other hand,. their interpretation of data they publish is fair game. I think, for example, they are underplaying the degree of illness out there, bit not necessarily severity.  That is, the denominator of illness is wide. The number of very sick seems accurate.

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by: DemFromCT @ Sat Jun 20, 2009 at 15:41:51 PM CDT

[ Parent ]

put differently

CDC doesn't deliberately lie, but they can get it wrong.

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by: DemFromCT @ Sat Jun 20, 2009 at 15:44:56 PM CDT

[ Parent ]

I have a question for you DemfromCT

I see a trend that seems to be going like this: A country or region gets some cases, and at first the symptoms from most all cases are mild. But after a time in that country/region the cases begin getting more severe, and then the first deaths appear. Then it seems like more and more deaths occur (and not just from "lingering illness" effects, as some of the new cases are sickening and dying rather quickly now.)

The odd thing to me is that it seems to be such a regional effect. It seems as if when the virus comes to a new area it acts just like the original strain, but after awhile it "adapts" to the human hosts in that area and becomes more and more virulent in that area (although not necessarily more transmissable).

What I had been expecting to see was a gradual change in the virus so that as it appears in a new area it is already in a more "adapated" and virulent form, but I don't seem to be seeing that. Most of the really serious cases and deaths are still in the North Americas, and seem to be growing in CFR, whereas in the more newly infected countries we are seeing more rapid spread but mostly mild cases and few deaths.

Is this what you see as well? If so, do you have a hypothesis to explain it? If not, if I am interpreting this trend wrongly, please set me straight. Thank you!

Always have a plan B.

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by: maryinhawaii @ Sat Jun 20, 2009 at 21:53:57 PM CDT

[ Parent ]

I'm not Dem ;-)

but let me take a stab at that question. It's a good and important one.

First, there is a lag phase between disease onset and death, so data on deaths is always going to lag behind reports of confirmed cases, such that it may appear to be milder in the beginning than it actually is.  It's only when the dust has settled, that someone has to go back and analyze the data and make the adjustment, that one can tell what happened at the beginning of the outbreak.

Second, there is also 'the fog of war'.  In a country with the new outbreak, by definition, they are not used to it.  Because the overwhelming majority of cases are mild, similar to seasonal flu, the ability to detect cases may vary significantly between countries and regions, such that it becomes hard to compare.

Related to this, is sufficient awareness to detect the initial fatal cases.  If they are not aware of this virus in general, some initial fatal cases may be missed.  This would especially apply in countries with lower health standards and where deaths from infectious diseases are more common than in the West, so it would be even easier to miss severe and fatal cases.

Put all that together, I think, unfortunately, we cannot yet determine whether fresh outbreaks in new countries are more severe in previously affected countries, or not.  In addition, in previous pandemics like 1918, severity can vary over a very wide range from country to country, for reasons that are still not well studied.  So any variation, or lack thereof, still fall into the rather wide range of severity possible, without necessarily implying any change in the virus itself.  

Quite simply, we just don't know.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 22:23:56 PM CDT

[ Parent ]

Is the "fog of war" as thick in new countries as it was in N.A.?

By the time Mexico, the US and Canada became aware there was a potential problem, you are right, there had been a great foothold gained and - especially in Mexico - lots of missed cases and even deaths that were not recognized and/or ascribed to swine flu.

However the countries getting it hence: Europe, Asia, South America, Australia, Africa...these all were already on alert. So I do not - with the exception of some very third world countries who probably aren 't even reporting cases yet - agree with your assumption that they lack "sufficient awareness to detect initial fatal cases".

From the reports we have been getting, countries are detecting cases by the thousands, are reporting those that are severe enough to require hospitalizatin, and are reporting the occasional deaths. My point is that those deaths are very very few in number....just as we saw in the US during the first weeks of the outbreak here. We were looking for them, but there were very few.

However more recently - as you yourself have pointed out several times, Susan - there have been what seem to be more deaths in the US that are happening rapidly from onset, rather than being the result of a "lag phase between disease onset and death".

My question - which was really skirted in your answer - is to do with this trend: Early in the advent of the disease in a region (ie, the US) there is a rapid spread but largely mild cases and few fatalities, but once it gets a foothold in that region the number of deaths and severe cases seem to increase. Granted this may be simply a matter of more people have it so the odds go up that more will die. That is probably the most likely explanation for why it appears to be following the same course in Europe, Asia, Australia et al: the virus hasn't really changed its lethality, it is simply a matter of numbers infected..and over time as you get more and more infected you will see more and more die at the same cfr.  

Always have a plan B.

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by: maryinhawaii @ Sun Jun 21, 2009 at 13:26:47 PM CDT

[ Parent ]

Yes, totally agree

My question - which was really skirted in your answer - is to do with this trend: Early in the advent of the disease in a region (ie, the US) there is a rapid spread but largely mild cases and few fatalities, but once it gets a foothold in that region the number of deaths and severe cases seem to increase. Granted this may be simply a matter of more people have it so the odds go up that more will die. That is probably the most likely explanation for why it appears to be following the same course in Europe, Asia, Australia et al: the virus hasn't really changed its lethality, it is simply a matter of numbers infected..and over time as you get more and more infected you will see more and more die at the same cfr.  

And, there are many uncertainties.  Despite whatever warning they get, I don't believe countries are uniformly alert to the need to test, nor are they uniformly committed to transparency.  Unless you do detailed analysis of hospitalization and death trends - and such information is not available in a timely nor easily accessible rate - it's hard to determine exactly what is happening in each country.  What I'm saying is, what you are saying is probable, but there really is too little information, and too early in the day, to tell for sure.  

During the SARS outbreak which got the whole world's attention, and where very extensive collaboration occurred, they were not able to figure out the CFR till almost near the end of the outbreak, and still the conclusions by different investigators differed.  That is what I mean by 'fog of war'.  There are many things that will make figures unreliable, and it takes a lot of work by committed researchers to tease out the information, account for any distortions such as under-reporting etc, before we have a vague sense of how things are.

There are exceptions.  Unfortunately, when the outbreak causes larger numbers of severe disease, like in Manitoba, then we get a better idea that at least in SOME places, and possibly (I say this with great caution) in some ethnic groups, the mortality may be higher.  But it may also be a function of access to care or underlying health condidion.

Which brings up one more point.  As the virus circulates in developing countries, we have many confounding factors, such as higher incidence of underlying severe conditions such as HIV or TB (which will increase deaths), more people self-treating and not presenting to doctors (which will decrease the number of identified cases), lack of surveillance capacity, more proportion of people in vulnerable age groups (ie overall more younger and less older people), and simply, still, lack of awareness by both the public and possibly health sector in large swathes of countryside, where HCWs are minimally trained and have little access to up-to-date information.

These are just some examples of how conditions on the ground will together create a picture that is hard to compare across countries.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sun Jun 21, 2009 at 13:59:33 PM CDT

[ Parent ]

in addition to what Susan wrote

there's this very true point from a recent Globe editorial:

Inevitably, an illness like flu that strikes patients with varying intensity will be treated in settings ranging from the home to hospital critical-care units.

There's varying intensity everywhere, so you need to have a large number of cases to see the small number of very ill. The very ill will always be better cataloged than the mild cases... we know that even with H5N1, when we look for and don't find those mild cases. H1N1 is quite different because there are so many inapparent illnesses.

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by: DemFromCT @ Sun Jun 21, 2009 at 08:00:42 AM CDT

[ Parent ]

A/H1N1 flu cases rise to 42 in Malaysia

"Malaysia confirmed seven new A/H1N1 flu cases Saturday morning, bringing the country's total number to 42.

   The Malaysian Health Ministry said a locally transmitted case was among the seven latest cases, but did not disclose more details.

   An 11-year-old local girl from a school in Kuala Lumpur was also among the new infected patients, according to the ministry.

   The girl had just returned home after a holiday trip to Melbourne with her grandmother who had been confirmed as the 30th case in the country on Friday.

   The girl went to school the following day, resulting in the home quarantine of her classmates..."

http://news.xinhuanet.com/engl...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:14:19 AM CDT

Macao's A/H1N1 flu cases climb to 3

" The two local patients, a 27-year-old air hostess and 54-year-old man, have been quarantined in local hospital and their conditions have remained stable so far, according to the Health Bureau.

   The air hostess traveled outside Macao several times between June 6 and 17, and she showed flu symptoms after flying back to Macao from Tokyo on June 17. The male patient, having been to Toronto, fell sick as he returned to Macao via neighboring Hong Kong in the same day. Both of them tested positive for the virus.

   Macao's first confirmed case concerned a Philippine man who flew to Macao from Manila. He was transferred to local hospital after being found having fever at the airport checkpoint. The Health Bureau later announced that he was infected with the A/H1N1 flu, and had him quarantined..."

http://news.xinhuanet.com/engl...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:16:09 AM CDT

Nine year old contracts first case of H1N1 in Antigua

"A nine-year-old child has contracted the first confirmed case of the Influenza A (H1N1) virus in Antigua and Barbuda, health officials have confirmed.

Chief Medical Officer Dr Rhonda Sealy-Thomas confirmed that the positive result but declined to disclose the name of the child's school. She said parents at the institution were being contacted..."

..."It added that the child remains isolated at home and is recovering well..."

http://www.dominicanewsonline....

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:21:43 AM CDT

China closes primary school after six pupils suffer A/H1N1 flu

"A primary school in south China's Guangdong Province have been shut after six first-form pupils were diagnosed with the A/H1N1 flu Friday, local government said Saturday.

   The local authorities gave no timetable for re-opening the Shipai Township Central Primary School in Dongguan City.

   The three boys and three girls, aged from seven to eight and from the same class, developed fever, cough and a sore throat Wednesday. They were confirmed as A/H1N1 flu cases Friday.

   The pupils were in stable conditions as their illness was mild, doctors said.

   Local health authorities said Saturday they have disinfected the school and were checking where the pupils were infected by the virus.

   The students had not left Dongguan for 10 days before they caught the flu, and there were earlier no such flu cases in the city. Guangdong, however, had confirmed 73 A/H1N1 flu cases by Friday, the largest number among mainland regions.

   Those who had close contact with the pupils have been ordered to stay at home for observation, the Dongguan city government said..."

http://news.xinhuanet.com/engl...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:23:40 AM CDT

(NY): 7 new H1N1 cases in Jefferson County

"Jefferson County now has 28 confirmed cases of the Swine Flu, technically known as H1N1..."

..."All of the newest cases involved children, all of whom have recovered or are recovering without complications..."

..."Although public health officials don't release the locations of H1N1 cases, it's believed most of them are centered in schools throughout the county."

http://www.newswatch50.com/new...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:26:57 AM CDT

That's my county. Two days ago they

reported 21 cases. I have seen an increase in people coughing and sneezing. Thank goodness school is finally out.  

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sat Jun 20, 2009 at 08:37:20 AM CDT

[ Parent ]

hi cottontop!

lots of people displaying symptoms here too. We've got one more week of school in Manitoba.

Hope you and yours stay healthy!

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 09:44:54 AM CDT

[ Parent ]

Twenty new cases of human swine influenza in Hong Kong

"Five of them are imported cases and 15 are local.

This brings to 255 the total number of human swine influenza (HSI) cases in Hong Kong.

The new cases involved 10 female and 10 male aged between 1 and 55 years old. All of them are in stable condition and will be arranged to public hospitals for isolation..."

..." Among the new cases included a teacher of Ling Liang Church M H Lau Secondary School, a student of Renaissance College, a student of YMCA of Hong Kong Christian College, a student American International School and four students of Australian International School.

All these schools were already closed in the past days..."

http://www.webnewswire.com/nod...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:28:47 AM CDT

Thailand reports 73 new cases of swine flu, total now 662

..." Public Health Minister Witthaya Kaewparadai said no one has died from the virus in Thailand and only 11 have needed to be hospitalized.

Most of the cases have been in Bangkok, with a lesser number found in 23 other provinces. Thailand has 76 provinces including Bangkok..."

http://www.monstersandcritics....

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:31:00 AM CDT

Three new swine flu cases in Delhi push India's tally to 53

"...Three more people have tested positive for the swine flu Saturday, including an indigenous case where the patient contracted the flu without going abroad," Delhi Health Secretary J.P. Singh told IANS.

The five-year-old boy who came back from Canada and was admitted to the Airport Health Organisation Hospital (APHO) two days back, has tested positive.

A 27-year-also man who travelled from Canada has also tested positive for swine flu at the Ram Manohar Lohia Hospital.

The third is an indigenous case in which a woman contracted the flu from her sister and nephew who had come from the US and tested positive June 17.

"They have been kept in isolation and their contacts are being identified and given tamiflu. We now have 15 swine flu cases in various hospitals in the capital," he said..."

http://www.thaindian.com/newsp...  

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:34:18 AM CDT

France: 1 case of swine flu confirmed at Paris school

..."Mayor Bertrand Delanoe says in a statement that the girl is hospitalized "but should be out soon." He says other pupils and staff at the school are being treated with anti-viral medicines.

He says the girl recently returned from a school trip to England.

France has seen relatively few cases of the A/H1N1 virus, with 150 cases nationwide confirmed as of Thursday, and no deaths..."

http://www.etaiwannews.com/etn...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 08:35:18 AM CDT

Chart Update new cumulative US death total 110

AZ      7
CA      8
CT      4
FL      1
IL      10
MA      1
MI      5
MN      1
MO      1
NV      1
NJ      4
NY      35
OK      1
OR      1
PA      3
RI      1
TX      10
UT      8
VA      1
WA      3
WI      4

US Total 110

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by: spartan @ Sat Jun 20, 2009 at 08:43:01 AM CDT

No let-up in flu cases, even though season's over

http://www.mcall.com/news/loca...

Three months after prime flu season, a local health lab is seeing as many cases as during the winter, with virtually all of them presumed to be swine flu.

The latest data from Health Network Laboratories, a subsidiary of Lehigh Valley Hospital and Health Network, shows the H1N1 virus, commonly known as swine flu, is continuing to circulate at a time when flu typically takes a rest until fall.

''For all practical purposes, if it's flu, it's swine flu,'' said Dr. Jeffrey Jahre, chief of infectious diseases for St. Luke's Hospital and Health Network.

Because the overwhelming number of cases are now swine flu, the Pennsylvania Department of Health is no longer testing every flu sample, said spokeswoman Stacy Kriedeman. She said the state lab, like Health Network Laboratories, has seen a tremendous number of flu cases.

Snip

The lab, one of the largest in the area, has tested more than 780 samples in the past two weeks. Of those, more than 100 cases each week have been positive for flu and all have been influenza type A. Beckwith said 98 percent of influenza type A cases ultimately test positive for swine flu.

The number of cases is equal to what was observed during the peak flu season in March, when other strains were still circulating.

''I think people need to realize that swine flu is circulating in our community, and people need to be aware that if they have flu-like symptoms, they should seek medical attention,'' said Beckwith, who is also on the board of the newly formed Lehigh-Northampton county health department.

Snip

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by: magdelaine @ Sat Jun 20, 2009 at 09:38:15 AM CDT

UK - Update on confirmed swine flu cases 20 June 2009

http://www.hpa.org.uk/webw/HPA...

247 further patients under investigation in England have today been confirmed through laboratory testing with swine flu. Together with the 12 laboratory confirmed cases in Scotland reported yesterday (June 19 2009) by the Scottish Government and one laboratory confirmed case in Northern Ireland reported yesterday by the Northern Ireland Executive this brings the total number of  laboratory confirmed UK cases identified since April 2009 to 2,244.

East of England 2 74

East Midlands 7 25

London 77 415

North East 1 27

North West 8 43

South East 18 145

South West 17 40

West Midlands 112 860

Yorkshire & Humber 5 49

TOTAL ENGLAND 247 1678

Northern Ireland - 14

Scotland - 549

Wales - 3

TOTAL UK 247 2244

There are another 1481 clinically presumed cases in the UK, some of which will be tested. birmingham still shows the greatest growth.
 

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by: UK - Bird @ Sat Jun 20, 2009 at 09:40:22 AM CDT

Vietnam's A/H1N1 flu cases rise to 37

"The Ho Chi Minh (HCM) City Health Department of Vietnam said Saturday a woman coming back from Australia became the country's 37th A/H1N1 flu case, local online news source the VietnamNet reported.

   The 37-year-old patient returned to Vietnam from Australia on the flight VN780 on Thursday. She, mother of two children, was confirmed positive to the A/H1N1 virus on Friday, said the source. The three patients are now being treated at the HCM City Hospital of Children No.1.

   Previously, in another report on Saturday, the VietnamNet said the country confirmed 36 A/H1N1 flu cases. Among those, 29 patients are from HCM City, three from the Mekong Delta province of Tien Giang, two from the southern province of Vung Tau, one from the central province of Khanh Hoa and one from the capital city of Hanoi..."

http://news.xinhuanet.com/engl...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 09:46:37 AM CDT

Brazil reports 17 new cases of A/H1N1 flu

..." raising the total number in the country to 131.

   Fourteen of the new patients are from the states of Sao Paulo, two from Goias and one from Mato Grosso do Sul. Three of them were infected in the Brazilian territory, while the others caught the flu during international trips..."

http://news.xinhuanet.com/engl...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 09:48:17 AM CDT

Number of swine flu infections in Lebanon hits 20

..."Those diagnosed with the virus include four students returning from the US, two travelers from Canada, including one child, and one person traveling from Australia, a statement by the ministry said.

The first three cases of swine flu in Lebanon were discovered on June 1. So far, there has been no local transmission of the virus and all diagnosed cases have been brought into Lebanon by travelers, the statement said..."

..." Authorities also issued a request that the Lebanese refrain from greeting their friends and family with the traditional three kisses on the cheek to reduce the likelihood of transmission. "If you visit someone, don't exchange kisses. Let's stop the social kissing habit," Health Minister Mohammad Jawad Khalifeh said at the time..."

http://www.zawya.com/Story.cfm...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 09:52:30 AM CDT

Saskatchewan H1N1 numbers again lead the prairie provinces

"Saskatchewan has realized a jump of 129 laborary confirmed cases of the H1N1 virus over the past two days..."

..."Saskatchewan now boasts 510 H1N1 cases, a jump from the 381 cases they had confirmed back on Wednesday..."

..."Canada wide, the Public Health Agency of Canada is reporting a total of 5,710 laboratory-confirmed cases of H1N1 flu virus, of which 349 cases required hospitalization and 13 deaths have resulted."

http://news.google.ca/news/url...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 10:02:00 AM CDT

Indonesia: How we face H1N1 pandemic

Sat, 06/20/2009 11:08 AM  
Tommy Dharmawan,JAKARTA | Opinion
http://www.thejakartapost.com/...

In late April, the WHO announced the emergence of a novel influenza A virus. This particular H1N1 strain had not previously circulated in humans. The virus spreads easily between humans and, in turn, from one country to another. As of June 12, 2009, 74 countries have officially reported nearly 30,000 cases of influenza A (H1N1), including 145 deaths.

How is the situation in Indonesia? To date, the vast majority of cases have been detected and investigated in comparatively well-off countries. Around 85 percent of the burden of chronic diseases is concentrated in low- and middle-income countries like Indonesia.

Although the pandemic appears to be moderately severe in comparison to well-off countries, it is prudent to anticipate a bleaker picture, as the virus spreads to areas with limited resources, poor health care and a high prevalence of underlying medical problems.

As of this writing there has still not been a reported H1N1 fatality in Indonesia, although there were some suspected cases. But although there have been no deaths, Indonesia should remain vigilant for several reasons.

Firstly, because the risk of H1N1 zoonosis transmission (from animal to human) remains high. We know that many pig and cattle farms nearby human settlements increases the risk of H1N1 transmission.

Secondly, because our neighbors like Australia are already seriously effected by the H1N1 pandemic. As of this writing, Australia has recoded 1307 cases, although it remains fatality free. So, prevention and preparation are not only a matter of regulation, but also direct implementation in society.

A pandemic should see Indonesian authorities implement preparedness plans, identify cases as efficiently as possible and minimize serious illness and deaths with proper treatment. The goal is to reduce the impact of the pandemic on society. Health systems need to be able to prevent, detect, treat and mitigate cases of this virus.

Other recommendations for preventing the spread of the virus among humans include using standard infection controls. This includes frequent washing of hands with soap and water or with alcohol-based hand sanitizers, especially after being out in public. Influenza not only can spread through coughs and sneezes, but can linger on tabletops, telephones and other surfaces and be transferred via the fingers to the mouth, nose or eyes.

The Indonesian government must ensure equal its rights to antiviral and vaccine stocks from WHO. The government must actively make these necessities more accessible and affordable to its people. Both antivirals and vaccines play important roles in treatment and prevention. However, existing stocks of antivirals are unlikely to meet the demand.

Therefore, the rational use of the limited resources will be essential. And medicines are only part of the response. The WHO is also deploying diagnostic kits, masks and gloves, teams of scientific experts and medical technicians so that countries in need can respond to local epidemics.

H1N1 is a new virus and only a small number of people with the infection have been treated for it with antiviral drugs. So far, most people who have contracted the new virus have experienced influenza-like symptoms (such as a sore throat, cough, runny nose, fever, malaise, headache, joint or muscle pain) and recovered without antiviral treatment.

Antiviral drugs may reduce the symptoms and duration of illness, just as they do for seasonal influenza. They also may contribute to preventing more severe cases and deaths.

Tests on viruses obtained from patients in Mexico and the United States have indicated that H1N1 is sensitive to neuraminidase inhibitors, but that the virus is resistant to the other class, the adamantanes.

The future severity of the H1N1 pandemic will depend on changes in the virus, underlying vulnerabilities and the limitation of the capacity of health care systems. Close monitoring of the disease and the regular sharing of information between the WHO and its member states during the pandemic period is essential to determine future severity of pandemic. Like Director-general of the WHO Margaret Chan said, "We are all in this together, and we will all get through this, together".

The writer is a lecturer of the University of Indonesia's faculty of medicine and was a 2007 Leiden Universiteit scholar on Cell Culture.

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by: Pixie @ Sat Jun 20, 2009 at 11:54:48 AM CDT

NY: Two Buffalo school students critically ill with swine flu

Updated: 06/20/09 12:50 PM
By Dan Herbeck
News Staff Reporter
http://www.buffalonews.com/cit...

Two students from the Buffalo Public Schools are now in critical condition with the swine flu, Philip Rumore, the president of the city teachers union said today.

And Rumore contends that school district officials have not done enough to alert parents and district employees to the seriousness of the situation.

"I understand there are privacy regulations, and no one has asked the district to release the names of these students. That's not what we're looking for. We pray for these kids," Rumore said.

"But there are safety issues here for students, parents and employees. People need to be more aware of how serious this is, and the importance of keeping their kids home if they are ill."

Rumore said he has learned that a 15-year-old boy from the Harvey Austin School 97 and a girl from the Charles Drew Science Magnet School 59 are both in Women & Children's Hospital in critical condition with the swine flu.

Teachers and parents at the two schools were notified by the district several days ago that the two students had swine flu, Rumore said, but in his view, the district has not made people aware of the seriousness of the situation.

Those allegations were vehemently denied by a school district spokesman, Stefan Mychajliw.

Over the past two months, Mychajliw said, the district has sent at least four letters to the parents of all children in the district about the dangers of the swine flu.

And parents and staffers in schools where students have been stricken have been alerted by telephone and e-mail, said Mychajliw, who sent copies of some of the communications to The Buffalo News.

"I'm blown away that anyone could make the accusation that we have not done enough to notify people," Mychajliw said. "We've done it again and again, and our biggest message has been telling parents, 'Don't send a sick child to school.' "

[snip]

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by: Pixie @ Sat Jun 20, 2009 at 12:02:17 PM CDT

I'd love to see those letters they sent to parents....

probably talked about hand washing, sneezing into your elbow and, of course, keeping your child home when he/she is sick. The usual wink wink, nod nod CYA stuff of bureaucrats walking the tightrope of public opinion, where one side is damned if you do and the other damned if you don't.

I don't envy the superintendent.

However I think the head of the union is probably right when he said the district has not made people aware of the seriousness of the situation.  I bet none of the letters told parents their kids could die.


Always have a plan B.

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by: maryinhawaii @ Sat Jun 20, 2009 at 21:59:17 PM CDT

[ Parent ]

More New Swine Flu Cases in Buffalo Schools and Niagara County

http://www.wgrz.com/news/local...

Another student in the Buffalo Public School District is in critical condition with swine flu.

Five new cases of H1N1 or swine flu, have also been diagnosed in Niagara County.

Buffalo Teachers' Federation President Phil Rumore says the Buffalo student who is critical attends the Harvey Austin School, which is also known as School 97.

On Thursday, a letter informing parents of another case of swine flu at a Buffalo Public School was sent home with students. The sick child attends Dr. Charles Drew Science Magnet School #59, next to the Science Museum. According to the Teachers Union President, the child is in critical condition.

Snip

The Niagara County Health Department is also confirming five new cases of H1N1 influenza, also known as Swine Flu, in school-aged children and one possible case in a pre-school aged child.

According to the health department, all six cases are in children ranging in age from three to 14 years old.

The health department says three children from Barker have fully recovered and returned to school. The three other children are from Niagara Falls and are not in school.

Despite these cases, the health department says it has not seen an increase in absenteeism reported by school districts.

The New York State Health Department announced new guidelines this week that discourage testing and treatment of mild, isolated flu-like-illnesses except in people with underlying medical issues.

The Niagara County Health Department says production of a new H1N1 vaccine is scheduled to begin next month, and it may be available by October.

Comment - the bolded statement above could be a bad thing; not an indication of the lack of illness in the community.

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by: magdelaine @ Sat Jun 20, 2009 at 12:10:09 PM CDT

OK let me think about this

You have by media accounts 1 or 2 or 3 (if I add this report to the one above, assuming they are different kids) students who are critically ill.  At the same time, they are saying there is no increase in absenteeism.

That doesn't make sense.  If there is no increase in absenteeism, that means not many kids are sick.  But if there are even a few critically ill kids while there AR among students is low, does that imply higher virulentce?  

Either that, or the statement of 'no increase in absenteeism' is, IMHO to be taken with a grain of salt.

I hope it's the latter, ie clueless or less than totally transparent bureaucracy rather than a suddenly more virulent strain that is LESS transmissible.  The science does not compute.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

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by: SusanC @ Sat Jun 20, 2009 at 12:17:42 PM CDT

[ Parent ]

I think one of the children in both reports is the same one

I don't know what's going on there either, but if you put the reports together I think you might conclude that parents are NOT keeping sick kids home. :(

---

by: magdelaine @ Sat Jun 20, 2009 at 12:23:36 PM CDT

[ Parent ]

New Vaccination Strategy May Protect Against Both Lethal 1918 And H5N1 Influenza Viruses

http://www.sciencedaily.com/re...

ScienceDaily (June 20, 2009) - A new study suggests that vaccination with 1918 H1N1 influenza virus-like particles not only protected mice and ferrets against the lethal 1918 influenza virus, but also displayed cross-reactive immunity against the potentially pandemic H5N1 influenza virus.

The researchers from the National Center for Immunization and Respiratory Diseases, Collaborating Centers for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and Novavax, Inc., Rockville, Maryland report their findings in the June 2009 issue of the Journal of Virology.

More than 220,000 hospitalizations and approximately 36,000 deaths are attributed to influenza A viruses each year. Since the first confirmed human cases of avian influenza in 1997, more than 400 additional human H5N1 infections have occurred of which an estimated 60% have been fatal. As new subtypes continue to emerge and the threat of a pandemic is at its highest in decades, researchers are pursuing vaccine strategies that can induce cross-reactive immunity against multiple strains of influenza viruses.

In prior research virus-like particle (VLP) vaccines have proven to be a promising new technology at preventing diseases in humans. VLPs resemble their live-virus counterparts and are readily processed by the immune system, however, they lack the RNA required for virus replication.
In this study researchers generated VLPs from the structural proteins of the 1918 H1N1 virus and compared their ability to protect mice and ferrets against a reconstructed 1918 virus and the highly pathogenic avian H5N1 virus that was isolated from a fatal human case. When immunized twice intranasally with H1N1 VLPs mice were highly protected against a lethal challenge with both the 1918 and H5N1 virus. In contrast, mice receiving two intramuscular immunizations of 1918 VLPs were only protected against the 1918 viral challenge. Mucosal vaccination with 1918 VLPs induced higher levels of cross-reactivity in mice and complete survival in ferrets challenged with a lethal dose of the H5N1 virus. Only a 50% survival rate was noted in intramuscularly immunized animals.

"These results suggest a strategy of VLP vaccination against a pandemic virus and one that stimulates heterotypic immunity against an influenza virus strain with threatening pandemic potential," say the researchers.

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by: magdelaine @ Sat Jun 20, 2009 at 12:18:35 PM CDT

well, that's very reassuring, for mice and ferrets ;-)

to progress from that to successful clinical trials to licensure to marketing a HUMAN vaccine, assuming nothing fails along the way, take about 10 years.

Just to put that in context.


All 'safety concerns' are hypothetical.  If not, they'd be called side effects...

---

by: SusanC @ Sat Jun 20, 2009 at 12:22:50 PM CDT

[ Parent ]

Bummer n/t

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by: magdelaine @ Sat Jun 20, 2009 at 12:24:31 PM CDT

[ Parent ]

If you're lucky enough to be a mouse

Even getting cancer isn't so bad.

It's if you're a human that these things are problematic.

---

by: Clawdia @ Sat Jun 20, 2009 at 13:26:00 PM CDT

[ Parent ]

Well... right up to the bit they cut you up. n/t

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by: UK - Bird @ Sat Jun 20, 2009 at 13:28:19 PM CDT

[ Parent ]

LOL - yes, there is that 'little' problem . . . n/t

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by: Clawdia @ Sat Jun 20, 2009 at 13:31:39 PM CDT

[ Parent ]

2 Buffalo students gravely ill with swine flu

http://www.fox44.net/Global/st...

A union official says two teenage students in the Buffalo school system there are hospitalized in critical condition with cases of swine flu.

City teachers union president Philip Rumore says 1 of the sick kids is a 15-year-old boy at the Harvey Austin School. The other is a young girl at the Charles Drew Science Magnet School.

He says both students are being treated at Women & Children's Hospital.

Spokesmen for the school district and the hospital declined to comment, citing medical privacy laws.

Hundreds of children in the state have been hospitalized for the virus, but most of the deaths have been among people between the ages of 25 and 64.

---

by: UK - Bird @ Sat Jun 20, 2009 at 13:40:04 PM CDT

Sorry a repeat, need more coffee n/t

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by: UK - Bird @ Sat Jun 20, 2009 at 13:44:39 PM CDT

[ Parent ]

UK-Bird, I just made some fresh! Come on over. n/t

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

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by: History Lover @ Sat Jun 20, 2009 at 14:51:43 PM CDT

[ Parent ]

I'm in a bad way, I'll stick it in an IV bag and plug it straight in. ;-) n/t

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by: UK - Bird @ Sat Jun 20, 2009 at 15:18:03 PM CDT

[ Parent ]

ROTF

I see you are are having one of my kind of bad days. OMG! Maybe it's contagious?

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 19:27:44 PM CDT

[ Parent ]

Phase 6 fool pandemic.

I'll give you the first op to list the symptoms.

Always have a plan B.

---

by: maryinhawaii @ Sat Jun 20, 2009 at 22:02:57 PM CDT

[ Parent ]

Egypt: 25 detained of Bird Flu suspicion

25 detained in 6 provinces on suspicion of bird flu
6-19-2009

Detained in hospital diets 6 provinces of the case 25 on suspicion of being infected with bird flu symptoms, in the lake, Dr. Yosri Congratulations, Under-Secretary, Ministry of Health in the county, the hospital admitted Damanhour arrested 9 suspected cases of the disease.

In the West held hospital admitted Tanta and Mahala 5 cases, were given the drug Tamiflu, and samples were taken from them, Minya hospital diets detained 4 suspected cases of bird flu.

DAMIETTA detained in hospital following the diets of 3 diagnosed with high temperature, running nose and cough have been sampling them for analysis, and Dakahliya detained in Mansoura Chest Hospital Hassan Shehata hope «14 years», and Adham Ayman Abdul Rauf «3 years» and Alaa Tariq Abdullah «5 years» Center Ghamr.

After ascertaining that Mkhaltthm birds dead, detained in hospital fevers QENA Humadi succeeded Yasser Mustafa Abdulnabi, «two», from the village of pacifism, and the straw was the removal of 18 birds for the breeding of domestic control Jailin 5 vendors and the execution of 500 birds.

google translated
orginal article

http://www.almasry-alyoum.com/...

United we stand: Divided we fall

http://cottontopssandbox.wordp...

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by: cottontop @ Sat Jun 20, 2009 at 13:55:06 PM CDT

I don't know which worries me most

A(H1N1) meeting H5N1

or multiple cases of swine flu covering up a growing number of bird flu cases.

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by: UK - Bird @ Sat Jun 20, 2009 at 13:59:33 PM CDT

[ Parent ]

The 2nd worries me more. n/t

To calm the wife buy cases of chocolate, to calm the husband buy cases of booze, and to calm the children...... heck the booze and chocolate should work.

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by: Oremus @ Sat Jun 20, 2009 at 14:12:41 PM CDT

[ Parent ]

New York City says H1N1 flu virus on the decline

http://www.queenscourier.com/a...

Seven weeks after St. Francis Preparatory High School documented the nation's first outbreak of the H1N1 virus, the New York City Health Department has reported that transmission of the virus, commonly known as swine flu, is on the decline.

The report, released June 12, painted the picture of a virus that peaked in late May, putting 567 people in the hospital by June 11 and claiming the lives of 16 as of June 15, according to the Department of Health and Mental Hygiene (DOHMH).

As of June 12, the cumulative number of confirmed H1N1 cases in the city was 863. The DOHMH noted, however, that the tally does not reflect the overall incidence of H1N1 flu, since only select cases are tested for the virus.

[snip]

Examining H1N1-related hospital admissions, the agency deduced that the virus disproportionately affected those with underlying risk factors for developing severe influenza or complications, and those below the age of 50. Some 80 percent of hospitalized patients had at least one known risk factor, most commonly asthma, pregnancy, diabetes, weakened immunity and cardiovascular disease.

Another risk factor was being under the age of two, a characteristic of 12 percent of the city's H1N1-related hospitalizations. Almost 80 percent of hospitalized patients were younger than 50, nearly half were under 18 and 20 percent were under the age of five.

While a citywide survey conducted between May 1 and May 20 found that flu-like illness was present in all five boroughs, overall prevalence was highest in Queens, where 9.4 percent of respondents reported symptoms. Moreover, the DOHMH survey, which involved telephone calls to around 1,000 households, found that Queens reported the most influenza-like illness among people under 18, with 16 percent.

The agency findings are in line with the city's H1N1-related school closures, which, beginning with the shuttering of St. Francis Prep in Fresh Meadows on April 27, were most widespread in Queens.

Overall, the DOHMH recommended the closing of around 60 city schools - 29 of which are in Queens - and, as of Monday, June 15, all schools had re-opened.

cont.

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by: UK - Bird @ Sat Jun 20, 2009 at 14:16:21 PM CDT

Honduras -engineer tests positive for swine flu

36-year-old engineer with a private firm has been diagnosed the first patient of swine flu in Maharashtra, health officials said today.

He is suspected to have contracted the disease during a recent visit to Honduras in Central America, they said. "We have received the medical reports of the patient, which confirmed that he had swine flu," Dr Pradeep Awate, who is heading the state health department's influenza cell, said.

The patient has been quarantined at the Kasturba Hospital and his condition is presently "normal", he said. "His condition is normal and he has only mild fever and running nose
.....
The results of his throat swab tests were received yesterday, which confirmed Swine flu, Awate said...
http://www.business-standard.c...

Be Prepared

---

by: DennisC @ Sat Jun 20, 2009 at 14:30:14 PM CDT

US - Commissioner: Health Department should provide more flu data

http://www.thetimesnews.com/ne...

County Commissioner Tim Sutton wants the ethnic breakdown of the six confirmed cases of the H1N1 flu virus in Alamance County and says County Health Director Barry Bass should provide it.

Bass said he doesn't have the data.

"First of all, people in this country have a right to have their health care information protected under HIPAA (a federal law that governs the release of health information), so therefore we do not vet information about particular cases," Bass said Monday as Sutton questioned him during a recent commissioners' meeting.

Statistics covering race, age, ethnicity and other information are sometimes released for some communicable diseases like sexually transmitted diseases, Bass said, but the H1N1 strain is relatively new and much of the data is unavailable.  Health officials are "in the process of developing new criteria" and have only the total number of cases so far, Bass added.

"That sounds fishy to me," Sutton said Thursday.

On Monday, Sutton told Bass during the commissioners' meeting that epidemiologist Dr. Megan Davies and another state health official told him there is "nothing that would forbid me from getting this information.

"There seems to be some confusion between the hierarchy in Raleigh and your office and I'd like to have it cleared up," Sutton continued.

Bass promised to find an answer to that question.

Sutton said he posed his questions to Bass because he is "an information hound" and wants to stay abreast of trends.

"If it's a statistic that they keep, I have a right to see it."

He thinks Bass and national health leaders are "being politically correct" about the origins of the virus and who has it. "I don't think they're giving us the whole story."

Sutton, a leading county immigration enforcement advocate, thinks some health issues like tuberculosis "are rearing their heads, in part, because of lax immigration enforcement."

Sutton said he has asked County Manager Craig Honeycutt to have Bass prepare a full report on all the services the Health Department provides. "That, and he asked for a breakdown of the use and ethnicity" of those using the services, Honeycutt said Friday.

Attempts to reach Bass for additional comment on Thursday and Friday were unsuccessful.

Before Sutton's request, the department had released some information about the six county residents with the H1N1, or swine flu, virus.

cont.

Comment It's not just us.

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by: UK - Bird @ Sat Jun 20, 2009 at 15:06:18 PM CDT

But that has a racist overtone

Sutton's comments suggest he's looking for data to bolster some attempt to "blame" the illness on some ethic group (might I guess: Hispanic?) - that's one of those ugly certainties about most disasters: some people care more about blame than solutions. I support full disclosure of facts, because the more minds working on this problem the better... but I am wary of that guy and his intentions!

Keep the information coming!

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by: Cathy M @ Sat Jun 20, 2009 at 17:21:28 PM CDT

[ Parent ]

I totally agree Cathy M

It does not sound at all like he would use the information so that he could facilitate better care for at risk groups . Quite the opposite if this article is correct.

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

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by: mojo @ Sat Jun 20, 2009 at 21:08:16 PM CDT

[ Parent ]

I totally agree Cathy M

It does not sound at all like he would use the information so that he could facilitate better care for at risk groups . Quite the opposite if this article is correct.

Life is not so short but that there is always time enough for courtesy. Ralph Waldo Emerson

---

by: mojo @ Sat Jun 20, 2009 at 21:08:49 PM CDT

[ Parent ]

First case of swine flu identified in Algeria

http://www.ennaharonline.com/e...

A first case of swine influenza has been detected in Algeria. This is an Algerian national, resident in Frankfurt in Germany and coming from Miami, United States of America.

This first case was detected at "Houari Boumediene Airport", thanks to a major health system of detection and control put in place since the spread of the virus in several countries around the world.

Algeria, aware of the seriousness of this new evil, has not skimped on important means to ensure the safety and health of people, mainly in this period of hot weather and holidays.

cont

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by: UK - Bird @ Sat Jun 20, 2009 at 15:08:18 PM CDT

Swine flu hits two summer camps in Minnesota

http://www.startribune.com/loc...

The national Muscular Dystrophy Association canceled its summer camping programs after 10 kids at a Minnesota camp contracted the illness. The flu also was reported at another camp -- also for kids with "underlying conditions," a state health official said.

[snip]

The national MDA also reported swine flu cases at camps in Utah and Pennsylvania.

cont.

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by: UK - Bird @ Sat Jun 20, 2009 at 15:10:45 PM CDT

India: Six more fall to Flu, 56 cases in total

"Six new cases have been reported from Delhi (3), Hyderabad (1), Bangalore (1) and Fatehgarh of Punjab (1). Of the 56 cases, 21 have been discharged while others remain admitted to hospitals," a Health Ministry official said..."

http://www.thestatesman.net/pa...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

---

by: MaMa @ Sat Jun 20, 2009 at 16:44:52 PM CDT

California: More swine flu cases in Solano County

"Nine more people have swine flu in Solano County, officials reported.

No one has died from the disease but one person, an unidentified child, was hospitalized in intensive care for several days with the H1N1 virus.

"The new cases this week reflect current H1N1 activity in our communities, and do not reflect a delay in receiving test results that was experienced in April and May due to intense demands placed on  health department, state and CDC laboratories," said Ronald W. Chapman, Solano public health officer, in a press release.

"While most of the cases have been relatively mild, one child was hospitalized in an intensive care unit for a period of time," he added. " The child's condition has since improved and while still hospitalized, the child is no longer in ICU."

The cases appeared throughout Solano County -- three each in Fairfield and Vacaville, two in Vallejo and one at Travis Air Force Base. The county previously reported a swine flu case in Benicia. The new cases affected people ranging in age from 6 to 32, with an average age of 19..."

http://www.examiner.com/x-1295...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

---

by: MaMa @ Sat Jun 20, 2009 at 16:48:42 PM CDT

Jordan:

 Jordan on Saturday confirmed its 12th H1N1 (swine) flu case, a 16-year-old Iraqi girl who entered the Kingdom from the US en route to Iraq, Health Ministry officials said.

The case, according to Primary Healthcare Director Adel Bilbeisi, is the first to be detected by the thermal scanning cameras installed at Queen Alia International Airport.

"The Iraqi girl was among a group of 14 Iraqi basketball players who arrived in Amman on Friday from the US on their way to Suleimaniyah," Bilbeisi said, adding that the scanners detected her high temperature and she was immediately isolated to undergo required tests.

Meanwhile, other team members tested negative and were allowed to leave Jordan for Iraq, according to the ministry's spokesperson Hatem Azruie."WHO has informed their office in Iraq and the Iraqi authorities about the team members, so that they can take precautionary measures," Azruie added..."

..."The ministry officials said that the Kingdom's first two confirmed cases, which were hospitalised last Tuesday, are expected to leave the hospital today. "We will do another test tomorrow [Sunday] for the girls and if they are completely healthy they will leave the hospital," Bilbeisi told a press conference yesterday..."

http://www.jordantimes.com/?ne...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 16:51:59 PM CDT

New Zealand: Woman with swine flu still critical in Wellington

"The tally of swine flu cases in New Zealand is expected to surge today as the Ministry of Health processes a backlog of test results..."

..."A woman described as morbidly obese and having respiratory problems, remains in a critical condition in Wellington Hospital as she battles the H1N1 virus.

She is being kept in isolation in the hospital's intensive care unit and is one of three patients and two nurses at the hospital with swine flu.

Most of the confirmed cases were in the three main cities..."

http://www.nzherald.co.nz/nz/n...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 16:54:52 PM CDT

42 confirmed (swine flu) virus A cases in Greece

"Three new A H1N1 (swine flu) cases were detected today 19 June 2009 in Greece. A Greek 37 years old man who came from Canada, a 13 Y/O Greek girl from Australia, a Greek boy 3,5 years and American boy 3,5 years both came from US. As it was announced confirmed cases in Greece rise to forty two (42). Fortunately 16 patients have been totally cured..."

http://www.express.gr/news/new...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 16:57:36 PM CDT

Quebec: Hospital asks kids, teens not to visit

"Maisonneuve-Rosemont hospital is asking people under the age of 18 not to visit in an effort to limit the possibility of H1N1 infections.

Officials say the virus is prevalent in children and teenagers.

"It's a rapidly evolving situation across Quebec and in particular across the island of Montreal," said a hospital spokesperson. "We feel that that is a reservoir that could bring the virus into the hospital in large quantities, so we'd like to keep that as limited as possible..."

http://montreal.ctv.ca/servlet...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

---

by: MaMa @ Sat Jun 20, 2009 at 16:59:16 PM CDT

Fiji: It's here

"FIJI has recorded its first case of influenza A (H1N1) through a 36-year-old male Fiji resident, who returned home from Australia on June 10.

The man, who lives in Nadi, was treated and is in a stable condition..."

..."All those who came in close contact with the man have also been tested for the virus.

According to Dr Saketa, the man is being treated with Tamiflu. A public health team is closely monitoring the man and his family who are being quarantined at their home."

http://www.fijitimes.com/story...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

---

by: MaMa @ Sat Jun 20, 2009 at 17:01:20 PM CDT

Israel: Kiryat Ono: 5 children from same class have swine flu

"Health Ministry defends decision to open school despite fact that five second-grade students are currently being treated in isolation after being infected with H1N1. 'It's a minor illness,' says spokeswoman..."

..."The students are believed to have been exposed to H1N1 from a girl in a different class in their grade, who in turn was exposed to the flu by a relative who recently returned form the United States.

Worried parents petitioned on Saturday for the school to remain closed on Sunday, but the principle announced classes would resume as usual.

On Friday ten students from the second grade class in question at Rimonim School in Kiryat Ono were absent because they felt unwell. Another two students left during the school day after coming down with fevers and flu-like symptoms.

The father of one of the second-graders spoke with Ynet. "On Friday we took him to Shiva Hospital, we saw a lot of other kids from his class there with their parents, a real reunion..."

http://www.ynetnews.com/articl...  

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

---

by: MaMa @ Sat Jun 20, 2009 at 17:09:55 PM CDT

A/h1n1 Flu Cases Exceed 20 In Finland

"Three new cases of A/H1N1 flu have been confirmed in Finland Saturday, raising the total number of diagnosed cases to 24, local media reported..."

..."All of the diagnosed cases in Finland have come from other countries, especially among travelers returning from the United States..."

http://www.turkishweekly.net/n...

Nobody made a greater mistake than he who did nothing because he could do only a little- Edmund Burke

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by: MaMa @ Sat Jun 20, 2009 at 17:11:40 PM CDT

5 new maps posted

nika with Central america, canada (new), south america and caricom; Okieman with new WHO world map.

Thanks, all!!

---

by: DemFromCT @ Sat Jun 20, 2009 at 18:49:55 PM CDT

Where are they posted? (n/t)

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by: AlohaOR @ Sat Jun 20, 2009 at 19:22:16 PM CDT

[ Parent ]

they have replaced the maps in this very diary n/t

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by: DemFromCT @ Sat Jun 20, 2009 at 19:23:47 PM CDT

[ Parent ]

here

http://www.newfluwiki2.com/upl...
http://www.newfluwiki2.com/upl...
http://www.newfluwiki2.com/upl...
http://www.newfluwiki2.com/upl...
http://www.newfluwiki2.com/upl...

I think they got lost when the new links were updated.

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by: DemFromCT @ Sat Jun 20, 2009 at 19:27:08 PM CDT

[ Parent ]

Got them, posted them, thank you (n/t)

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by: AlohaOR @ Sat Jun 20, 2009 at 19:32:56 PM CDT

[ Parent ]

here

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by: DemFromCT @ Sat Jun 20, 2009 at 19:29:47 PM CDT

[ Parent ]

Thanks Dem

On the WHO Update 51 map I have added the number of cases for countries with more than 2000 reported cases.  They are the United States, Mexico, Canada, Australia and Chile.

I am impressed with Nika's Photoshop maps.  You have done a very good job Nika.  Thank you.

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by: Okieman @ Sat Jun 20, 2009 at 21:36:00 PM CDT

[ Parent ]

Europe Map

I've sent Dem a map of Europe using the WHO Update 51 information.

I've also been taking a closer look at the WHO data versus the European Centre for Disease Prevention and Control.  The ECDC is maintaining a more up to date dataset.  Since this data is more to the moment and also since Nika is using it I will change over to using it also for future maps.  That way the information in the maps should match better since they are from the same day and same reporting agency.  I will still use the CDC data for the U.S.  
Now...if these agencies would simply start posting their own maps we wouldn't have to be making all these maps ourselves.  I know they utilize GIS systems.  

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by: Okieman @ Sat Jun 20, 2009 at 22:06:05 PM CDT

[ Parent ]

garsh

aww thnx.  It drives the DH nuts tho, when he sees me updating them he asks how armageddon is coming along (winks).

I smile and tease him back about something he does that drives me nuts (usual spousal abuse sort of stuff).

My only question is whether its informative for people to have these updated on a daily basis (is that overload?) or on a weekly basis?

Some of the regions seem quiescent (like the sunny caribbean tho that could be damage control) ..

South America and Chile in particular is really interesting.  Chile is just exploding with cases.

I am thinking of adding to the Canadian map to show where the impacted 1st nations regions are, the map doesnt make it obvious to a non-canadian like me

---

by: nika @ Sun Jun 21, 2009 at 09:19:18 AM CDT

[ Parent ]

Please post new news stories to...

News Reports for June 21, 2009

Thank you!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 23:01:39 PM CDT

Great job today everyone!

Lot's of good articles and comments posted today and some really good maps too. Looking at the list of countries in the headline summary tells me you have covered a lot of real estate in the last 24 hours!  

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     

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by: Carol@SC @ Sat Jun 20, 2009 at 23:12:18 PM CDT

[ Parent ]

And the same to you, Miss Carol. n/t

"I am opposed to any form of tyranny over the mind of man."  Thomas Jefferson

---

by: History Lover @ Sun Jun 21, 2009 at 13:37:18 PM CDT

[ Parent ]